喜怒不节则伤脏，脏伤则病起于阴，清湿袭虚，则病起于下；风雨袭虚，则病起于上。是虽三部，
至于淫 ，不可胜数。（百病治生，无非外感内伤，上中下三部之分也，至其浸淫流 ，
则变有不可胜数矣。）然风雨寒热，不得虚，邪不能独伤人。卒然逢疾风豪雨而不病者，盖无虚。故邪不能
独伤人，必因虚邪之风，与其身形两虚相得，乃客其形。两实相逢，众人肉坚。其中于虚邪也，因于天时，
与其身形，参以虚实，大病乃成。气有定舍，因处为名。上下中外，分为三员。（从冲后来者为虚
风，伤人者也。从所居之乡来者为实风，主生长、养万物者也，若人气不虚，虽遇虚风，不能伤人，故必以
身之虚，而逢天之虚，两虚相得，乃客其形也，若天有实风，人有实气，两实相逢，而众人肉坚，邪不能入矣。
三员，如虚邪之中人，病因表也；积聚之已成，病因内也；情欲之伤脏，病在阴也。）是故虚邪之中人也，
始于皮肤。皮肤缓则腠理开，开则邪从毛发入，入则抵深，深则毛发立，毛发立则淅然，故皮肤痛。（此下言
阳邪传舍之次也。邪之中人，必由表入里，始于皮肤。表虚则皮肤缓，故邪得乘之。邪在表则毛发竖立，因
而淅然。寒邪伤卫则血气凝滞，故皮肤为痛。凡寒邪所袭之处必多酸痛，察系何经，在阴在阳，
或深或浅，从可知矣。诊表证者，当先乎此也。）留而不去，则传舍于络脉。在络之时，痛于肌肉。其痛
之时息，大经乃代。（邪在皮毛，当治于外。留而不去，其入渐深，则传舍于络脉，络浅于经，故痛
于肌肤之间。若肌肉之痛时渐时息，是邪将去络而深，大经代受之矣。）
留而不去，传舍于经。在经之时，洒淅喜惊。（络浮而浅，经隐而深。邪气自络入经，犹为在表，故洒淅恶寒，
然经气连脏，故又喜惊也。）留而不去，传舍于输。在输之时，六经不通，四肢则肢节痛，
腰脊乃强。（凡诸输穴，皆经气聚会之处。其所留止，必在关节溪谷之间，故邪气自经传舍于输，则六经为
之不通，而肢节腰脊，为痛为强也。）留而不去，传舍于伏冲之脉。在伏冲之时，体重身痛。（伏冲之脉，
即冲脉之在脊者，以其最深，故曰“伏冲”。邪自经输留而不去，深入于此，故为体重身痛等病。）
留而不去，传舍于肠胃。在肠胃之时，贲向腹胀，多寒则肠鸣飧泄，食不化，多热则溏出麋。（邪气自经
入脏，则传舍于肠胃，而为奔向腹胀之病。寒则澄澈清冷，水谷不分，故为肠鸣飧泄，食不化；热则浊垢下
注，故为溏为麋，以麋秽如泥也。）留而不去，传舍于肠胃之外，募原之间，留着于脉，稽留而不去，
息而成积。（肠胃之外，募原之间，谓皮里膜外也，是皆隐蔽曲折之处，气血不易流通，若邪气留着于中，
则止息成积，如疟痞之属也。）或着孙脉，或着络脉，或着经脉，或着输脉，或着于伏冲之脉，或
着于膂筋，或着于肠胃之募原，上连于缓筋。邪气淫 ，不可胜论。（此下言邪气所着，淫 之变也。募原，
如手太阴中府为募，太渊为原之类也。缓筋，支别之柔筋也。）其着孙络之脉而成积者，其
积往来上下，臂手孙络之居也。浮而缓，不能句积而止之，故往来移行肠胃之间。水凑渗注灌，濯濯有音，
有寒则 胀满，雷引，故时切痛。（凡络脉之细小者，皆孙络也。句，拘也。邪着孙络成积者，其积能往来上
下，盖积在大肠、小肠之络，皆属于经，其络浮而浅，缓而不急，不能句积而留止之，故移行于肠胃之间，
若有水则凑渗注灌，濯濯有声。若有寒则为胀满及雷鸣相引，时为切痛。句，音垢。）其着于阳明之经，则
挟脐而居，饱食则益大，饥则益小。（足阳明经挟脐下行，故其为积则挟脐而居也，阳明属胃，受水谷之
气，故饱则大，饥则小。）其着于缓筋也，似阳明之积，饱食则痛，饥则安。（缓筋，在肌肉之间，故似阳明
之积。饱则肉壅，故痛；饥则气退，故安。）其着于肠胃之募原也，痛而外连于缓筋，饱
食则安，饥则痛。（肠胃募原，痛连缓筋，饱则内充外舒，故安，饥则反是，故痛。）其着于伏冲之脉者，
揣之应手而动，发手则热气下于两股，如汤沃之状。（伏冲，其上行者循背里，终于督脉，其下
行者注少阴之大络，出于气街，循阴股内廉，入 中，故揣按于股则应手而动，若起其手，则热气下行于两股
间，此邪着伏冲之验也。）其着于膂筋，在肠后者，饥则积见，饱则积不见，按之不得。（膂，脊骨
也，脊内之筋曰“膂筋”，故在肠胃之后，饥则肠空，故积可见，饱则肠满蔽之，故积不可见，按之亦不
可得也。）其着于输之脉者，闭塞不通，津液不下，孔窍干壅。（输脉者，所以通血气，若闭塞不通，则津液干
壅。）此邪气之从外入内，从上下也。（此总结上文邪气之起于阳者，必自外而内，从上而下也。）积之始生，
得寒乃生，厥乃成积也。厥气生足 ， 生胫寒，胫寒则血脉凝涩，血脉凝涩则寒气上入于肠胃，入于肠胃
则胀， 胀则肠外之汁沫迫聚不得散，日以成积。（此言寒气下逆之成积者也。厥气，逆气也。寒逆于下，
故生足 ，谓肢节痛滞不便利也。由胫寒而血气凝涩，则寒气自下而上，渐入肠胃，肠胃寒则阳气不化，故
为胀，而肠外汁沫迫聚不散，则日以成积矣。）卒然多食饮则肠满，起居不节、用力过度则络脉伤∶
阳络伤则血外溢，血外溢则衄血；阴络伤则血内溢，血内溢则后血。肠胃之络伤则血溢于肠外，肠胃有寒汁
沫与血相搏，则并合凝聚不得散，而积成矣。（此言食饮、起居失节之成积者也。卒然多食饮，谓食不从缓，
多而暴也、肠胃运化不及，则汁溢膜外，与血相搏，乃成食积，如婴童痞疾之类是也。又或起居用力过度，
致伤阴阳之络，以动其血，瘀血得寒汁沫相聚于肠外，乃成血积，此必纵肆口腹，及举动不
慎者多有之。）卒然外中于寒，若内伤于忧怒，则气上逆。气上逆则六输不通，温气不行，凝血蕴里而不散，
津液涩渗，着而不去，而积皆成矣。（此言情志内伤而挟寒成积者也。寒邪既中于外，忧怒复伤其内，气
因寒逆则六经之输不通，暖气不行则阴血凝聚，血因气逆而成积，此必情性乖戾者多有之也。）其生于阴者，
忧思伤心，重寒伤肺，忿怒伤肝，醉以入房，汗出当风伤脾，用力过度，若入房汗出，浴则伤肾。（此言情
欲伤脏，病起于阴也。伤心者病在阳，伤肺者病在气，伤肝者病在血，伤脾者病在营卫，伤肾者病
在真阴，凡伤脏者，皆病生于阴也。）此内外三部之所生病者也。
邪气之中人，高下有度∶身半以上者，邪中之也；身半以下者，湿中之也。（阳受风气，阴受湿气也。）
中于阴则溜于腑，中于阳则溜于经。阴之与阳，异名同类，上下相会，经络之相贯，如环无端，或于阴，
或于阳，上下左右，无有恒常。诸阳之会，皆在于面。中人也，方乘虚时，及新用力。若饮
食汗出，腠理开而中于邪，中于面则下阳明，中于项则下太阳，中于颊则下少阳。（此言邪之中于阳经也。
手、足六阳，俱会于头面，故为诸阳之会。凡足之三阳，从头走足，故中于面则自胸腹下行于阳
明经也，中于项则自脊背下行于太阳经也，中于颊则自胁肋下行于少阳经也。脉遍周身者，惟足六经耳，
故但言足也。）其中于膺背两胁，亦中其经。（膺在前，阳明经也；背在后，太阳经也；两胁在侧，少阳经也。
中此三阳经与上同。）中于阴者，常从臂 始。夫臂与 ，其阴皮薄，其肉淖泽，故俱受于风，独伤其阴。
（此言邪之中于阴经也。 ，足胫也。淖泽，柔润也。臂 内廉曰阴，手、足三阴之所行也。其皮薄，
其肉柔，故邪中于此，则伤其阴经。）身之中于风也，不必动脏。入于阴经，脏气实不能客，还之于腑，
故曰∶“中阳则溜于经，中阴则溜于腑。”（邪中阴经，当内连五脏，而脏气固者，邪不能客，未必
动脏，则还之于腑，仍在表也，故邪中阳者溜于三阳之经，邪中阴者溜于三阴之腑，如心之及小肠，脾之
及胃，肝之及胆，包络之及三焦，肾之及膀胱，此以邪中三阴，亦有表证，明者所当察也。）邪之中人脏者，
愁忧恐惧则伤心，形寒饮冷则伤肺。以其两相感触，中外皆伤，故气逆而上行。（此下言邪之中于五脏也。然
必其内有所伤，而后外邪得以入之。心藏神，忧愁恐惧则神怯，故伤心也；肺合皮毛，其脏畏寒，
形寒饮冷故伤肺也。若内有所伤而外复有感，则中外皆伤，故气逆而上行，在表则为寒热疼痛，在里则为喘咳
呕哕等病。）有所堕坠，恶血留内，有所大怒，气上而不下，积于胁下，则伤肝；（肝藏血，其
志为怒，其经行胁下也。）有所击仆，若醉入房，汗出当风，则伤脾；（脾主肌肉，饮食击仆者伤其肌肉，醉
后入房，汗出当风者因于酒食，故所伤皆在脾。）有所用力举重，若入房过度，汗出浴水，则伤肾；
（肾主精与骨，用力举重则伤骨，入房过度则伤精，汗出浴水则水邪犯其本脏，故所伤皆在肾。）五脏之中
风者，阴阳俱感，邪乃得住。（此承上言必由中外俱感，而后邪乃得往。往，进也。）虚邪之中身也，洒淅
动形，正邪之中人也微，先见于色，不知于身，若有若无，若亡若存，有形无形，莫知其形。
有一脉生数十病者，或痛或痈，或热或寒，或痒或痹或不仁，变化无穷，皆邪气之所生也。（一脉，犹
言一经也。邪气，即风也。虚邪贼风，善行数变，故其为病变化无穷。）气者，有真气，
有正气，有邪气。真气者，所受于天，与谷气并而充身也。（真气，即元气也。气在天者，受于鼻而喉主之；
在水谷者，入于口而咽主之。然钟于未生之初者曰“先天之气”，成于已生之后者曰“后天之气”，气
在阳分即“阳气”，在阴即“阴气”，在表曰“卫气”，在里曰“营气”，在脾曰
“充气”，在胃曰“胃气”，在上焦曰“宗气”，在中焦曰“中气”，在下焦曰“元阴、元阳之气”，皆
无非其别名耳。）正气者，正风也，从一方来，非
实风，又非虚风也。（从一方来，谓太乙所居之方也，风得时之正者为正风，然正风、实风，本同一方，而
此曰“非实风”者，以正风之来徐而和，故曰“正气”，实风之来暴而烈，故与虚风对言也。）邪气者，
虚风之贼伤人也，其中人也深，不能自去。（从冲后来者为虚风，其中人也甚，故深入不能自去。）正风者，
其中人也浅，合而自去，其气来柔弱，不能胜真气，故自去。（合而自去，谓邪与正合，而正胜之，
故自去也。）虚邪之中人也，洒淅动形，起毫毛而发腠理。其入深，内搏于骨则为骨痹，搏于筋则为筋挛，
搏于脉中则为血闭不通，则为痈，搏于肉与卫气相搏，阳胜者则为热，阴胜者则为寒，寒则真气去，去则虚，
虚则寒搏于皮肤之间。（洒淅，寒栗也。邪之中人，变不可测，故无分皮肉筋骨，着则为病也。若
与卫气相搏，阳胜则热，阴胜则寒，皆邪气也。曰“寒则真气去，去则虚”。盖气属阳，人以气为主，寒胜
则阳虚，所重在气也。阳气既虚，则阴寒搏聚于皮肤之间矣。）其气外发，腠理开，毫毛摇，气往来行则为
痒，留而不去则痹，卫气不行，则为不仁。（邪之在表者其气外发，或腠理开，则汗为不敛；或毫毛动摇，
则毛瘁而败；或气往来行，则流而为痒；或邪留不去，则痛而为痹；若卫气受伤，虚而不行，则不知痛
痒，是谓不仁。）虚邪偏客于身半，其入深，内居荣卫，荣卫稍衰，则真气去，邪气独留，发为偏枯；其邪
气浅者，脉偏痛。（虚邪若中于半身，其入深而重者，则营卫衰，真气去，乃发为偏枯，若邪
之浅者，亦当为半身偏痛也。）虚邪之入于身也深，寒与热相搏，久留而内着∶寒胜其热则骨痛肉枯，热
胜其寒则烂肉腐肌为脓，内伤骨，内伤骨为骨蚀。（邪中于外者必寒，气蓄于内者必热。
寒邪深入，与热相搏，欠留不去，必内有所着，故寒胜则伤阳而为痛为枯，热胜则伤阴而为脓为腐，其最深者
内伤于骨，是为骨蚀，为侵蚀及骨也。）有所疾前筋，筋屈不得伸，邪气居其间而不反，发为筋溜。
（有所疾前筋，谓疾有始于筋也。筋之初着于邪，则筋屈不得伸，若久居其间而不退，则发为筋溜。筋溜者，
有所流注而结聚于筋也，即赘瘤之属。下仿此。）有所结气，归之卫气，留之不得反，津液久留，合而
为肠溜。（邪有所结，气必归之，故致卫气失常，留而不反，则蓄积于中，流注于肠胃之间，乃结为肠溜。）
久者数岁乃成，以手按之柔，已有所结；气归之，津液留之，邪气中之，凝结日以易甚，连以
聚居，为昔瘤。（其有久者，必数岁而后成也。然其始也，按之虽柔，或上或下，已有所结；及其久也，气渐
归之，津液留之，复中邪气，则易于日甚，乃结为昔瘤。昔瘤者，非一朝一夕之谓。）以手按之坚，有
If joy and anger are not regulated, the Zang organs will be injured; injury to the Zang organs causes disease to arise from Yin. Clear dampness attacking deficiency causes disease to arise from the lower part of the body; wind and rain attacking deficiency cause disease to arise from the upper part. Although these are divided into three regions (upper, middle, and lower), the variations of pathogenic factors infiltrating and flowing are countless. (The origin of all diseases lies in either external contraction or internal injury, categorized into the upper, middle, and lower regions; however, their infiltrating and flowing changes are too numerous to count.) However, wind, rain, cold, and heat cannot injure people alone without deficiency. Those who suddenly encounter fierce winds and heavy rains but do not fall ill do so because they lack deficiency. Therefore, pathogenic factors cannot injure people alone; it requires the combination of deficient pathogenic winds and the body's deficiency for the pathogen to lodge in the form. When substantial winds (normal climatic winds) meet with robust human Qi, the muscles of the masses remain firm. Contracting illness due to deficient pathogens involves both the heavenly timing (deficient winds) and the body's condition (Qi deficiency); when these two deficiencies coincide, major illnesses are formed. Qi has fixed abodes, named according to their locations. The upper, lower, exterior, and interior are divided into three zones (Winds coming from the direction opposite to the prevailing season are deficient winds, which injure people. Winds coming from the direction of the prevailing season are substantial winds, which promote growth and nourish all things. If human Qi is not deficient, even encountering deficient winds cannot injure people; thus, it must be the body's deficiency meeting the heaven's deficient wind, where the two deficiencies coincide, allowing the pathogen to lodge. If there is a substantial wind and robust human Qi, the two substantials meet, and the masses' muscles remain firm, preventing pathogen entry. The "three zones" refer to: if deficient pathogens enter people, the cause is on the exterior; if accumulations are formed, the cause is internal; if emotions injure the Zang organs, the disease is in Yin.). Thus, when deficient pathogens enter the human body, they begin at the skin. If the skin is lax, the interstices (Cou Li) open; once open, pathogens enter through hair follicles. Once entered, they reach depth; at depth, hair stands erect. When hair stands erect, one feels shivering, hence skin pain. (This section below describes the sequence of transmission of Yang pathogens. Pathogens entering people must go from the exterior to the interior, starting at the skin. Exterior deficiency leads to lax skin, allowing pathogens to take advantage. Pathogens at the exterior cause hair erection, leading to shivering. Cold pathogens injuring Wei Qi cause blood and Qi stagnation, resulting in skin pain. Wherever cold pathogens attack, there is often soreness and pain; by observing which meridian is involved, whether in Yin or Yang, and whether deep or shallow, this can be known. In diagnosing exterior syndromes, one should start here.) If they remain and do not depart, they transmit to the Luo vessels. At this stage, pain occurs in the muscles. The pain may cease intermittently, and then the larger Jing meridians take over. (Pathogens at the hair and skin should be treated externally. If they remain and do not depart, they penetrate deeper, transmitting to the Luo vessels. Luo vessels are shallower than Jing meridians, so pain occurs between the muscles and skin. If muscle pain comes and goes, it indicates pathogens are leaving the Luo vessels and going deeper, causing the larger Jing meridians to assume the burden.) If they remain and do not depart, they transmit to the Jing meridians. At this stage, one experiences chills and is prone to fright. (Luo vessels are floating and shallow; Jing meridians are hidden and deep. Pathogens moving from Luo to Jing are still considered at the exterior, hence chills. However, since Jing Qi connects to the Zang organs, one also becomes prone to fright.) If they remain and do not depart, they transmit to the Shu points. At this stage, the six Jing meridians become obstructed, causing pain in the limbs and joints, and stiffness in the waist and spine. (All Shu points are places where Jing Qi gathers. Pathogens lodging here are found between joints and valleys. Thus, when pathogens transmit from Jing meridians to Shu points, the six Jing meridians become obstructed, causing pain and stiffness in the limbs, joints, waist, and spine.) If they remain and do not depart, they transmit to the Fu Chong vessels. At this stage, the body feels heavy and painful. (The Fu Chong vessel refers to the portion of the Chong Mai within the spine; it is called "Fu Chong" because it is the deepest. Pathogens lodging in the Jing and Shu and remaining there penetrate deeply into this area, causing symptoms like heaviness and body pain.) If they remain and do not depart, they transmit to the stomach and intestines. At this stage, there is epigastric distension and abdominal fullness. With excess cold, there is borborygmus and undigested stool diarrhea; with excess heat, there is loose, foul-smelling discharge. (Pathogens entering the Zang from the Jing transmit to the stomach and intestines, causing epigastric distension and abdominal fullness. Cold causes clear fluids and undigested food to separate poorly, leading to borborygmus and undigested stool diarrhea; heat causes turbid waste to flow downward, leading to loose, muddy stools.) If they remain and do not depart, they transmit outside the stomach and intestines, between the Mu Yuan (epigastric region/mesentery), lodging in the vessels. Remaining and not departing, they stagnate and form accumulations. (Outside the stomach and intestines, between the Mu Yuan, refers to the space beneath the skin and outside the membranes. These are concealed and tortuous areas where Qi and Blood do not circulate easily. If pathogens lodge here, they stagnate and form accumulations, such as malaria-related masses.) Some attach to Sun vessels, some to Luo vessels, some to Jing meridians, some to Shu vessels, some to Fu Chong vessels, some to Lv Jin (back muscles), some to the Mu Yuan of the stomach and intestines, connecting upwards to Huan Jin (relaxed tendons). The infiltration and changes of pathogens are too numerous to discuss. (This section below discusses the sites of pathogen attachment and the variations of infiltration. Mu Yuan examples include Zhongfu (Mu point) and Taiyuan (Yuan source point) of the Hand Taiyin Lung Meridian. Huan Jin refers to branch tendons that are soft.) For those forming accumulations by attaching to Sun vessels, the accumulation moves up and down, residing in the Sun vessels of the arms and hands. Since they are floating, lax, and unable to confine the accumulation, it migrates between the stomach and intestines. If water gathers and permeates, it makes a gurgling sound. With cold, there is abdominal distension and thunderous rumbling, causing sharp pain. (All fine vessels are called Sun vessels. Ju means to confine. Pathogens attaching to Sun vessels form accumulations that move up and down, likely in the Luo vessels of the large and small intestines, which belong to the meridians. These vessels are floating, shallow, and lax, unable to confine the accumulation, so it migrates between the stomach and intestines. If water gathers, it makes a gurgling sound. If cold is present, it causes distension and thunderous rumbling, leading to intermittent sharp pain. Ju is pronounced 'gou'.) Those attaching to the Yangming Meridian reside flanking the navel. After a full meal, the accumulation enlarges; when hungry, it shrinks. (The Foot Yangming Stomach Meridian runs flanking the navel downwards, so its accumulation resides flanking the navel. Yangming belongs to the Stomach, which receives grain and water Qi; thus, it enlarges after eating and shrinks when hungry.) Those attaching to Huan Jin resemble Yangming accumulations: painful after eating, comfortable when hungry. (Huan Jin is between the muscles, resembling Yangming accumulations. After eating, muscles become congested, causing pain; when hungry, Qi retreats, bringing comfort.) Those attaching to the Mu Yuan of the stomach and intestines are painful and connect outwardly to Huan Jin. They are comfortable after eating and painful when hungry. (Pain in the stomach/intestine Mu Yuan connects to Huan Jin. After eating, the interior fills and exterior relaxes, bringing comfort; when hungry, the reverse occurs, causing pain.) Those attaching to the Fu Chong vessel feel pulsating upon palpation. Upon releasing pressure, heat flows down to both thighs, feeling like hot water pouring. (The ascending Fu Chong follows the inside of the back to the Du Mai; the descending part injects into the large Luo of Shaoyin, emerges at Qichuang, follows the inner thigh, and enters the knee. Palpating the thigh elicits a pulse; releasing hand pressure causes heat to flow down between the thighs, verifying pathogen attachment to Fu Chong.) Those attaching to Lv Jin behind the intestines: the accumulation is visible when hungry, invisible when full, and unpalpable. (Lv refers to the vertebral column; tendons inside the spine are called "Lv Jin," located behind the stomach and intestines. When hungry, the intestines are empty, making the accumulation visible; when full, the intestines obscure it, making it invisible and unpalpable.) Those attaching to Shu vessels cause obstruction, preventing the descent of Body Fluids, leading to dryness and congestion of orifices. (Shu vessels facilitate the circulation of Blood and Qi; if obstructed, Body Fluids become dry and stagnant.) This describes pathogens entering from the exterior to the interior, from above to below. (This summarizes the previous text: pathogens arising from Yang must enter from the exterior to the interior, from above to below.) Accumulations begin to form when cold is acquired; Jue Qi (rebellious Qi) leads to the formation of accumulations. Jue Qi arises from cold feet; cold originates in the calves. Cold calves cause blood vessels to coagulate and stagnate; stagnant blood vessels allow cold Qi to ascend into the stomach and intestines. Entering the stomach and intestines causes distension; distension forces the juices and foam outside the intestines to gather and not disperse, gradually forming an accumulation. (This explains how downward-rebellious cold Qi forms accumulations. Jue Qi is rebellious Qi. Cold rebelling downward causes cold feet, meaning joint pain and immobility. From cold calves, Blood and Qi stagnate; cold Qi ascends from below to the stomach and intestines. Cold in the stomach and intestines prevents Yang Qi transformation, causing distension. The juices outside the intestines are forced together and cannot disperse, gradually forming an accumulation.) Sudden overeating causes intestinal fullness; irregular lifestyle and excessive effort damage Luo vessels. Damage to Yang Luo vessels causes external bleeding (epistaxis); damage to Yin Luo vessels causes internal bleeding (hematochezia). Damage to Luo vessels of the stomach and intestines causes blood to overflow outside the intestines. If there is cold in the intestines, the juices/foam fight with the blood, coagulating and not dispersing, forming an accumulation. (This explains how dietary and lifestyle irregularities form accumulations. Sudden overeating implies rapid, excessive consumption, overwhelming intestinal digestion, causing juices to overflow outside membranes and fight with blood, forming food accumulations, similar to pediatric痞疾. Alternatively, excessive effort damages Yin and Yang Luo vessels, disturbing blood. Stasis fighting with cold juices outside the intestines forms blood accumulations, common in those who indulge in food and act carelessly.) Sudden external cold combined with internal emotional injury (worry/anger) causes Qi to rebel upward. Upward-rebellious Qi obstructs the six Shu points, preventing the movement of warming Qi. Coagulated blood remains inside without dispersing; Body Fluids become涩 (astringent/stagnant), adhering and not departing, forming accumulations. (This explains how emotional internal injury combined with cold forms accumulations. External cold and internal worry/anger cause Qi to rebel due to cold, obstructing the six Jing Shu points. Lack of warming Qi causes Yin Blood to coagulate; blood forms accumulations due to Qi rebellion, common in those with erratic temperaments.) Those arising from Yin: worry and thought injure the Heart; severe cold injures the Lungs; anger injures the Liver; drinking and then having intercourse, sweating and exposing to wind injures the Spleen; excessive effort, or intercourse while sweating followed by bathing, injures the Kidneys. (This discusses how desires and emotions injure Zang organs, causing disease from Yin. Injury to the Heart affects Yang; injury to the Lungs affects Qi; injury to the Liver affects Blood; injury to the Spleen affects Ying and Wei; injury to the Kidneys affects True Yin. All injuries to Zang organs result in disease arising from Yin.) These are the diseases generated in the interior, exterior, and three regions.
Pathogens entering people have a specific pattern regarding height: pathogens above the midpoint of the body are Wind; pathogens below the midpoint are Dampness. (Yang receives Wind; Yin receives Dampness.) Those entering Yin meridians flow into the Fu organs; those entering Yang meridians flow into the Jing meridians. Yin and Yang have different names but are of the same category, meeting above and below, with meridians interconnecting like a circle without end. They may affect Yin or Yang, high or low, left or right, without constant regularity. The convergence of all Yang meridians is in the face. When pathogens enter people, it is during times of deficiency or recent exertion. If sweating after eating/drinking opens the Cou Li, pathogens enter. Those striking the face descend to the Yangming Meridian; those striking the neck descend to the Taiyang Meridian; those striking the cheek descend to the Shaoyang Meridian. (This discusses pathogens entering Yang meridians. The six Hand and Foot Yang meridians converge at the head and face, making them the convergence of all Yang. The three Foot Yang meridians run from head to foot; thus, striking the face descends to Yangming, striking the neck descends to Taiyang, and striking the cheek descends to Shaoyang. Only the six Foot meridians pervade the whole body, so only they are mentioned.) Those striking the chest, back, and flanks also strike their respective meridians. (The chest anteriorly is Yangming; the back posteriorly is Taiyang; the flanks laterally are Shaoyang. Striking these three Yang meridians is the same as above.) Those entering Yin meridians usually start from the arms and calves. The arms and calves have thin skin on their Yin surfaces and soft, moist flesh, so they are susceptible to Wind, uniquely injuring Yin. (This discusses pathogens entering Yin meridians. Tui refers to the calf. Nao Ze means soft and moist. The medial aspect of arms and calves is Yin, where the three Yin meridians of Hand and Foot travel. Thin skin and soft flesh allow pathogens to enter and injure Yin meridians.) Wind invading the body does not necessarily injure the Zang organs. If it enters Yin meridians, but the Zang Qi is robust and cannot host the pathogen, it returns to the Fu organs. Hence, it is said: "Striking Yang flows into Jing meridians; striking Yin flows into Fu organs." (Pathogens entering Yin meridians should internally connect to the five Zang organs. However, if Zang Qi is solid, the pathogen cannot lodge and may not injure the Zang, returning instead to the Fu organs, remaining at the exterior. Thus, pathogens striking Yang flow into the three Yang Jing meridians, while those striking Yin flow into the three Yin Fu organs, such as Heart connecting to Small Intestine, Spleen to Stomach, Liver to Gallbladder, Pericardium to Sanjiao, and Kidney to Bladder. Even when pathogens strike the three Yin, there may be exterior signs, which astute practitioners should observe.) Pathogens injuring the Zang organs: sorrow and fear injure the Heart; physical cold and cold drinks injure the Lungs. Because these two interact, both interior and exterior are injured, causing Qi to rebel and ascend. (This section below discusses pathogens injuring the five Zang organs. Internal injury must occur first before external pathogens can enter. The Heart houses Shen; sorrow and fear weaken Shen, thus injuring the Heart. The Lungs govern skin and hair and fear cold; physical cold and cold drinks injure the Lungs. If there is internal injury and subsequent external contraction, both interior and exterior are injured, causing Qi to rebel and ascend. Externally, this manifests as fever, chills, and pain; internally, as asthma, cough, vomiting, and hiccups.) Falling from heights leaves evil blood inside; extreme anger causes Qi to rebel upward and not descend, accumulating under the hypochondrium, injuring the Liver. (The Liver stores Blood, its emotion is Anger, and its meridian travels through the hypochondrium.) Being struck or fallen, or having intercourse after drunkenness with sweat exposed to wind, injures the Spleen. (The Spleen governs muscles; being struck injures muscles. Drunken intercourse with sweat exposed to wind involves alcohol and food, so the injury is in the Spleen.) Heavy lifting, excessive intercourse, sweating and bathing in water injure the Kidneys. (The Kidneys govern Essence and bones. Heavy lifting injures bones; excessive intercourse injures Essence; sweating and bathing invite Water pathogens to attack the root organ, so the injury is in the Kidneys.) For Wind entering the five Zang organs, both Yin and Yang must be affected for the pathogen to settle. (This continues saying that only when both interior and exterior are affected can the pathogen advance. Advance means to enter.) Deficient pathogens shaking the body cause shivering; normal pathogens enter subtly, first appearing in complexion, unnoticed in the body, seeming to exist and not exist, having form and no form, unknown in shape. One meridian can generate dozens of diseases: pain, abscesses, heat, cold, itching, numbness, or anesthesia. Changes are infinite, all generated by pathogens.
Qi includes True Qi, Zheng Qi (Upright Qi), and Xie Qi (Pathogenic Qi). True Qi is received from Heaven and combines with Grain Qi to fill the body. (True Qi is Yuan Qi. Qi from Heaven is received through the nose and governed by the throat; Qi from food and drink is received through the mouth and governed by swallowing. That concentrated before birth is "Pre-heaven Qi"; that formed after birth is "Post-heaven Qi". Qi in the Yang aspect is "Yang Qi", in Yin is "Yin Qi", on the exterior is "Wei Qi", in the interior is "Ying Qi", in the Spleen is "Chong Qi", in the Stomach is "Stomach Qi", in the Upper Jiao is "Zong Qi", in the Middle Jiao is "Zhong Qi", and in the Lower Jiao is "Yuan Yin/Yuan Yang Qi". All are merely aliases.) Zheng Qi is Zheng Feng (Upright Wind), coming from one direction, neither Shi Feng (Substantial Wind) nor Xu Feng (Deficient Wind). (Coming from one direction refers to the direction of Tai Yi. Wind obtaining the correct seasonal quality is Zheng Feng. Although Zheng Feng and Shi Feng come from the same direction, this says "not Shi Feng" because Zheng Feng arrives gently and harmoniously, hence called "Zheng Qi", whereas Shi Feng arrives violently and fiercely, contrasted with Xu Feng.) Xie Qi is the thief of Xu Feng injuring people; it enters deeply and cannot leave on its own. (Xu Feng coming from the opposing direction injures people severely, penetrating deeply and unable to self-resolve.) Zheng Feng enters superficially, combining and resolving itself. Its Qi arrives softly and cannot overcome True Qi, so it resolves on its own. (Combining and resolving means the pathogen meets upright Qi, which overcomes it, causing resolution.) When Xu Feng enters people, it causes shivering, raises hair, and opens Cou Li. Penetrating deeply, if it clashes with bone, it causes Bone Bi; with sinews, Sinew Spasm; in vessels, Blood closure and obstruction, leading to abscesses; with flesh and Wei Qi, if Yang prevails, it causes Heat; if Yin prevails, it causes Cold. Cold causes True Qi to depart; departure leads to deficiency; deficiency allows Cold to clash between the skin. (Xixi means shivering/chills. Pathogens entering people are unpredictable, affecting skin, flesh, sinews, and bones alike. Clashing with Wei Qi, Yang prevalence causes Heat, Yin prevalence causes Cold, both being pathogenic. "Cold causes True Qi to depart" emphasizes that Qi belongs to Yang, and humans rely on Qi. Cold victory leads to Yang deficiency. Once Yang Qi is deficient, Yin-Cold gathers between the skin.) If Qi emits outward, opening Cou Li and shaking hair, flowing Qi causes itching; if lingering, it causes Bi; if Wei Qi does not flow, it causes anesthesia (numbness). (When pathogens are at the exterior, Qi emits outward. If Cou Li opens, sweat does not收敛 (retain); if hair shakes, hair becomes brittle; if Qi flows, it causes itching; if pathogens linger, pain and Bi result; if Wei Qi is injured and fails to flow, pain and itch are not felt, called Anesthesia.) If Xu Feng lodges偏 (laterally) on half the body, penetrating deeply and residing in Ying and Wei, slight decline of Ying and Wei causes True Qi to depart, leaving only Pathogenic Qi, developing into hemiplegia (Pian Gu). If the pathogen is shallow, there is unilateral pain. (If Xu Feng strikes half the body deeply and heavily, Ying and Wei decline, True Qi departs, causing hemiplegia. If the pathogen is shallow, it causes unilateral pain.) Xu Feng entering deeply, with Cold and Heat clashing, lingering internally: if Cold prevails over Heat, bone pain and muscle wasting occur; if Heat prevails over Cold, flesh rots and muscles decay into pus, internally injuring bone, leading to Bone Erosion. (External pathogens are necessarily Cold; internal accumulation is necessarily Heat. Deep Cold clashing with Heat, lingering internally, causes internal lodging. Cold victory injures Yang causing pain and wasting; Heat victory injures Yin causing pus and rot. The deepest level internally injures bone, called Bone Erosion, eroding to the bone.) Diseases affecting sinews previously: sinews contract and cannot extend; if pathogens reside there and do not return, it develops into Jin Liu (Sinew Mass). (Diseases affecting sinews mean the disease starts in the sinews. Initially, pathogens attach to sinews, causing contraction and inability to extend. If they reside there long-term without retreating, Jin Liu develops. Jin Liu refers to flow and aggregation in sinews, similar to tumors. The following is analogous.)结气 (Knotted Qi) returns to Wei Qi, lingering and not returning. Body Fluids remain long-term, combining to form Chang Liu (Intestinal Mass). (Where Qi knots, it must return to Wei Qi, causing Wei Qi dysfunction. Lingering and not returning, it accumulates internally and flows between stomach and intestines, knotting into Chang Liu.) Long-term cases take years to form. Pressing with hand feels soft, indicating prior knotting; Qi returns, Body Fluids remain, pathogens enter, condensing daily becoming worse, clustering together, forming Xi Liu (Ancient/Long-standing Tumor). (Long-term cases take years. Initially, pressing feels soft, with knotting anywhere. Over time, Qi gradually returns, Body Fluids remain, pathogens re-enter, worsening daily, knotting into Xi Liu. Xi Liu means not formed overnight.) Pressing with hand feels hard, having...